Prevalence, risk factors, and predictors of pelvic organ prolapse: a community-based study.

OBJECTIVE: This study aimed to determine the prevalence of pelvic organ prolapse (POP) in a village in East Lebanon and to evaluate related risk factors and clinical predictors. METHODS: Five hundred four ever-married women aged 15 to 60 years were interviewed and underwent physical and pelvic examinations and laboratory testing. Prolapse was determined according to a simplified version of the POP quantification system. RESULTS: Two hundred fifty-one (49.8%) women had clinically significant POP. When stratified by life decade POP prevalence was 20.4% for women aged 20 to 29 years 50.3% for women aged 30 to 39 years 77.2% for women aged 40 to 49 years and 74.6% for women aged 50 to 59 years suggesting a plateau in prevalence in the decade after menopause. Clinically significant POP was found in 3.6% of nulliparous 6.5% of primiparous 22.7% of secondiparous 32.9% of triparous and 46.8% of tetraparous women. Increasing age increasing vaginal parity and a body mass index higher than 24 kg/m were found to be significant risk factors for POP with relative risks of 1.09 (P < 0.001) 2.31 (P < 0.0001) and 1.62 (P = 0.048) respectively. Combined clinical symptoms of pelvic heaviness urinary disturbances and a feeling of bulge in the vagina were predictive of POP. CONCLUSIONS: Our findings suggest that cost-efficient interventions to reduce the burden of POP in this and similar remote communities include the following: family planning awareness campaigns focusing on the risks of grand multiparity; nutritional education and weight management programs to help reduce the progression of POP before the age of menopause; and consideration of symptom-based screening to identify affected women who might benefit from a referral to specialty care at a tertiary care center.